THE ROYAL WOLVEHRAMPTON HOSPITALS NHS TRUST. Head of Planning/Emergency Preparedness

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1 THE ROYAL WOLVEHRAMPTON HOSPITALS NHS TRUST Report To: Trust Board 12 April 2010 Report of: Subject: Author: Chief Operating Officer Emergency Preparedness Head of Planning/Emergency Preparedness Purpose of Report To provide Trust Board with the Quarterly (as at 31 March 2010) up date on Emergency Preparedness activities & Winter Planning. Implications Financial Human Resources Healthcare Policy Standards for Better Health Core Standard 24 Other Legal Civil Contingencies Act 2004 Emergency Planning Guidance 2005 Emergency Response & Recovery Guidance Aug 2009 The Operating Framework for the NHS in England 2010/11 Emergency Preparedness (Chapter 2, priorities - page 20, points ). Review Committee Approval Date Nil Recommendation(s) Trust Board to approve the Quarterly (as at 31 March 2010) Emergency Preparedness activities. Trust Board to approve the debrief on Winter Planning

2 THE ROYAL WOLVERHAMPTON HOSPITALS NHS TRUST Report to: Trust Board 12 April 2010 Report of: Subject: Chief Operating Officer/ Head of Planning & Emergency Preparedness Quarterly update on Emergency Preparedness Activities & Outcome of Winter Planning. 1.0 INTRODUCTION 1.1 This report covers the following areas for Emergency Preparedness: Emergency Planning Winter Planning Business Continuity Management (BCM) Warning & Informing Co-operation & Information Sharing Training Testing & Exercises 2.0 INTRODUCTION In accordance with our requirements as highlighted by the Civil Contingencies Act (2004) and the Operating Framework for 2010/2011, this is to give the Board an update on the Trust s Emergency Preparedness activities for the first quarter (as at 31 March 2010) and the outcome of winter planning QUARTERLY UPDATE AS AT 31 MARCH EMERGENCY PLANNING Major Incident As part of the recommendations from the Assessment of CBRN readiness by WMAS, there was a requirement to improve the modesty of patients. In response to this, the Trust has now purchased a new decontainer unit in replacement of a tent for CBRN. This is due on site by the end of March/beginning of April Review of CBRN protocols & guidelines underway to support the new decontainer unit. 1

3 Review of Major Incident action cards since EMERGO exercise (September 2009) has taken place H1N1 (2009) Influenza Pandemic Planning Swine Flu Swine Flu is still classed as a threat. It is highly likely that the pandemic H1N1 (2009) virus will be the predominant influenza strain in the 2010/2011 influenza season. Vaccination now protects individuals against the disease and its complications when it returns later in the year. The Wolverhampton Region Pandemic Planning Committee stood down formally on the 9 March Several debriefs have taken place internally and externally at local and national level. The Trust undertook it s debrief session on the 22 February 2010 and was also part of the Winter Planning debrief on the 11 March Highlights from the debrief were: o Disease did not happen as per plans resulting in radical changes to plans which were achieved. o Pattern of first wave different to previous ones. o Across the UK there was a focus on Children and not adults although in relation to the numbers the Trust was seeing more young adults than children. o Good command & control structure in place for the Trust. o Fantastic team work across the Trust. o Communication streams in place but could be improved. o Well prepared in relation to stock management due to previous planning. o Plans in place to increase capacity and were used as part of the winter pressures. A balance between normal work & pandemic was achieved. o Vaccination well orchestrated and good uptake from the critical areas and front line services. o Data collection & processes to the Centre (SHA) have been challenging due to several requests and ever changing processes required. 2

4 Next steps o Continue to provide to all staff members the vaccine o Robust business continuity planning o Review of Influenza Plan o Review of internal communication & information processes 3.2. WINTER PLANNING This Winter the Trust was faced with several challenges, with the pending Influenza Pandemic, coping with an unprecedented Norovirus outbreak and extreme bad weather. This year has gone on record for being the worst winter for over 30 years. Highlights from the debrief held 11 March 2010 o Winter planning commenced in June 2009, earlier than previous year, this supported the pre-recruitment of extra nurses and the understanding of our flexing capacity requirements. o Less conflict was maintained between Emergencies & Electives & A&E throughout. The Trust maintained its elective work throughput and achieved the 98% A&E target. The intensive planning of elective surgery proved productive. o Flexed capacity well planned for, and was utilised according to plan giving the Trust greater control on its capacity. o Clinical & non clinical training for all non-core staff established and staff across the Trust contributed to supporting the clinical areas in times of need, which was appreciated by ward staff. o The command & control structure which was in place, gave greater support to the Trust s decisions on a daily basis. o Partnership working evident with early involvement of PCT & Social Services in the planning process. o There were enhanced On Call Managers and Director Support. o Excellent team approach by all o Plans worked well. 3

5 Lessons learned: o Earlier involvement in the Ambulance Service, and establishment of a better Ambulance Service handover. o 24/7 cover for some of the support services was needed and their involvement earlier in the planning process. o Managing the hospital at night needs to be more robust o Establishment of a live bed state which would have supported capacity management during the Winter pressures, but the challenges faced by the Trust for Norovirus and influenza pandemic. The Winter Planning Group will review the findings as it begins planning for 2010/ BUSINESS CONTINUITY MANAGEMENT (BCM) In August 2009, the Board approved the Business Continuity Strategy for the Trust, which highlighted the approach needed to embed business continuity management within the organisation and its critical activities. Since that period a great deal of work has been undertaken with the development of individual business continuity plans (bcps) for services across the Trust. An element of this work had already commenced to support pandemic influenza planning. BCPs have now been developed and are currently in the process of being walked through to assess the robustness of these. The Business Continuity Sub Group which has been established will continue to monitor the effectiveness of these as part of its role WARNING & INFORMING The Trust is required to actively warn and inform its staff, patients and members of the public who work or visit the Trust with information regarding what to do in emergency situations and how the Trust responds to this The Emergency Preparedness Intranet page for staff is continuing to evolve with useful sources of information The first Emergency Preparedness newsletter for staff & the public was produced in February 2010 and distributed across the Trust, and is available on the Emergency Preparedness web site Emergency Preparedness forms part of the Trust Induction on a monthly basis with 150 new starters in attendance for the first quarter where an outline of emergency preparedness was given and an outline of their responsibilities. 4

6 3.4. CO-OPERATION WITH OTHER AGENCIES The Trust has an obligation to co-operate and share information both internally and with a variety of organisations including emergency services, local authorities, other health organisations etc in the development of the Trust s resilience The Head of Emergency preparedness is continuing to be actively involved in the LHRF (Local Health Resilience Forum) and the WRF (Wolverhampton Resilience Forum) promoting co-operation and understanding between the Trust and those involved in emergency planning on a monthly basis Internally, the Trust s working groups for emergency preparedness continue to meet TRAINING Training remains a top priority for the Head of Emergency Preparedness and the Clinical leads from the respective emergency planning work groups, with the aim of offering out bespoke training. Training for this quarter has been minimal due to winter pressures, with a plan for more in the next quarter. Training Number of Staff Date ERMA Command Training 2 Executive Directors 17 February & 18 March 2010 Renal Physicians as part of Silver Command 5 Consultants 25 March TESTING/EXERCISING The Trust as a minimum must conduct a live exercise every three years, a table top exercise once a year, which the Trust has planned for the latter part of 2010/2011 and a communication cascade test every six months. The Trust undertook its 6 monthly communication test on the 16 th February 2010, with the next one planned for the 5 th August 2010 linked to WMAS. The communication tested stand by and declared as outlined in the cascade list. The test went well with some minor recommendations. 5

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